Validation of the NIH Toolbox in Individuals with Neurologic Disorders

Archives of Clinical Neuropsychology, 2017 · DOI: 10.1093/arclin/acx020 · Published: March 18, 2017

Simple Explanation

The NIH Toolbox (NIHTB) is a tool designed to efficiently assess motor, sensory, cognitive, and emotional functioning. This study aims to validate the NIHTB for use with individuals who have spinal cord injury (SCI), traumatic brain injury (TBI), or stroke, by examining how they perform on the test compared to healthy individuals. The results showed differences in performance across the groups, suggesting the NIHTB can be a useful tool for clinicians to understand the different challenges faced by individuals with these conditions.

Study Duration

Not specified

Participants

604 individuals: 209 SCI, 184 TBI, and 211 stroke participants

Evidence Level

Not specified

Key Findings

1
Individuals with SCI, TBI, and stroke showed increased risk for motor impairment compared to normative standards and matched controls.
2
Individuals with stroke and TBI performed more poorly on fluid cognition measures than individuals with SCI.
3
Participants in all three groups showed comparably poor psychological well-being, social satisfaction, and self-efficacy.

Research Summary

This study evaluated the validity of the NIH Toolbox (NIHTB) for assessing motor, sensory, cognitive, and emotional function in individuals with spinal cord injury (SCI), traumatic brain injury (TBI), and stroke. The results indicated that individuals with SCI, TBI, and stroke demonstrated elevated risk for clinical impairment on measures of motor function, fluid cognition, sensation, and emotion. The findings support the validity of the NIHTB for use in individuals with neurological conditions, providing clinicians with insights into the different problems experienced by these groups.

Practical Implications

Clinical Assessment

The NIHTB can be used to broadly evaluate emotion, motor, and sensory function, in addition to cognitive function.

Differential Diagnosis

The addition of sensory measures into a clinical battery may assist with differential diagnosis, and in identifying sensory deficits that might not otherwise be identified or targeted for treatment interventions.

Rehabilitation Planning

Assessment of these domains may provide important information with clinical implications potentially for rehabilitation need and daily functioning capacities among these individuals.

Study Limitations

1
Participants were at least 1-year post-injury; thus, findings are not generalizable to individuals with acute injuries.
2
Comorbid conditions were not collected. Future work is needed to understand how comorbid conditions influence performance on the NIHTB.
3
Effort was not assessed nor did we query litigation status. Future work is needed to describe the impact that suboptimal effort or malingering has on the different domains of the NIHTB.

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